Validation of PROMIS Physical Function Instruments in Patients With an Orthopaedic Trauma to a Lower Extremity

Nan E Rothrock, Aaron James Kaat, Mark S. Vrahas, Robert V. OʼToole, Sarah K. Buono, Suzanne Morrison, Richard Gershon

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To evaluate the reliability, convergent validity, known-groups validity, and responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility Computer Adaptive Test (CAT) and PROMIS Physical Function 8a Short Form. DESIGN: Prospective cohort study. SETTING: Two Level-I trauma centers. PATIENTS: Eligible adults with an isolated lower extremity trauma injury receiving treatment were approached consecutively (n = 402 consented at time 1, median = 80 days after treatment). After 6 months, 122 (30.3%) completed another assessment. INTERVENTION: Cross-sectional and longitudinal monitoring of patients. MAIN OUTCOME MEASUREMENTS: Floor and ceiling effects, reliability (marginal reliability and Cronbach's alpha), convergent validity, known-groups discriminant validity (weight-bearing status and fracture severity), and responsiveness (Cohen's d effect size) were evaluated for the PROMIS Mobility CAT, PROMIS Physical Function 8a Short Form, and 5 other measures of physical function. RESULTS: PROMIS PFSF8a and Foot and Ankle Ability Measure Activities of Daily Living Index had ceiling effects. Both PROMIS measures demonstrated excellent internal consistency reliability (mean marginal reliability 0.94 and 0.96; Cronbach's alpha = 0.96). Convergent validity was supported by high correlations with other measures of physical function (r = 0.70-0.87). Known-groups validity by weight-bearing status and fracture severity was supported as was responsiveness (Mobility CAT effect size = 0.81; Physical Function Short Form 8a = 0.88). CONCLUSIONS: The PROMIS Mobility CAT and Physical Function 8a Short Form demonstrated reliability, convergent and known-groups discriminant validity, and responsiveness in a sample of patients with a lower extremity orthopaedic trauma injury.

Original languageEnglish (US)
Pages (from-to)377-383
Number of pages7
JournalJournal of orthopaedic trauma
Volume33
Issue number8
DOIs
StatePublished - Aug 1 2019

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Information Systems
Orthopedics
Lower Extremity
Wounds and Injuries
Weight-Bearing
Trauma Centers
Physiologic Monitoring
Activities of Daily Living
Patient Reported Outcome Measures
Reproducibility of Results
Ankle
Foot
Cohort Studies
Prospective Studies
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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title = "Validation of PROMIS Physical Function Instruments in Patients With an Orthopaedic Trauma to a Lower Extremity",
abstract = "OBJECTIVES: To evaluate the reliability, convergent validity, known-groups validity, and responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility Computer Adaptive Test (CAT) and PROMIS Physical Function 8a Short Form. DESIGN: Prospective cohort study. SETTING: Two Level-I trauma centers. PATIENTS: Eligible adults with an isolated lower extremity trauma injury receiving treatment were approached consecutively (n = 402 consented at time 1, median = 80 days after treatment). After 6 months, 122 (30.3{\%}) completed another assessment. INTERVENTION: Cross-sectional and longitudinal monitoring of patients. MAIN OUTCOME MEASUREMENTS: Floor and ceiling effects, reliability (marginal reliability and Cronbach's alpha), convergent validity, known-groups discriminant validity (weight-bearing status and fracture severity), and responsiveness (Cohen's d effect size) were evaluated for the PROMIS Mobility CAT, PROMIS Physical Function 8a Short Form, and 5 other measures of physical function. RESULTS: PROMIS PFSF8a and Foot and Ankle Ability Measure Activities of Daily Living Index had ceiling effects. Both PROMIS measures demonstrated excellent internal consistency reliability (mean marginal reliability 0.94 and 0.96; Cronbach's alpha = 0.96). Convergent validity was supported by high correlations with other measures of physical function (r = 0.70-0.87). Known-groups validity by weight-bearing status and fracture severity was supported as was responsiveness (Mobility CAT effect size = 0.81; Physical Function Short Form 8a = 0.88). CONCLUSIONS: The PROMIS Mobility CAT and Physical Function 8a Short Form demonstrated reliability, convergent and known-groups discriminant validity, and responsiveness in a sample of patients with a lower extremity orthopaedic trauma injury.",
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Validation of PROMIS Physical Function Instruments in Patients With an Orthopaedic Trauma to a Lower Extremity. / Rothrock, Nan E; Kaat, Aaron James; Vrahas, Mark S.; OʼToole, Robert V.; Buono, Sarah K.; Morrison, Suzanne; Gershon, Richard.

In: Journal of orthopaedic trauma, Vol. 33, No. 8, 01.08.2019, p. 377-383.

Research output: Contribution to journalArticle

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T1 - Validation of PROMIS Physical Function Instruments in Patients With an Orthopaedic Trauma to a Lower Extremity

AU - Rothrock, Nan E

AU - Kaat, Aaron James

AU - Vrahas, Mark S.

AU - OʼToole, Robert V.

AU - Buono, Sarah K.

AU - Morrison, Suzanne

AU - Gershon, Richard

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N2 - OBJECTIVES: To evaluate the reliability, convergent validity, known-groups validity, and responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility Computer Adaptive Test (CAT) and PROMIS Physical Function 8a Short Form. DESIGN: Prospective cohort study. SETTING: Two Level-I trauma centers. PATIENTS: Eligible adults with an isolated lower extremity trauma injury receiving treatment were approached consecutively (n = 402 consented at time 1, median = 80 days after treatment). After 6 months, 122 (30.3%) completed another assessment. INTERVENTION: Cross-sectional and longitudinal monitoring of patients. MAIN OUTCOME MEASUREMENTS: Floor and ceiling effects, reliability (marginal reliability and Cronbach's alpha), convergent validity, known-groups discriminant validity (weight-bearing status and fracture severity), and responsiveness (Cohen's d effect size) were evaluated for the PROMIS Mobility CAT, PROMIS Physical Function 8a Short Form, and 5 other measures of physical function. RESULTS: PROMIS PFSF8a and Foot and Ankle Ability Measure Activities of Daily Living Index had ceiling effects. Both PROMIS measures demonstrated excellent internal consistency reliability (mean marginal reliability 0.94 and 0.96; Cronbach's alpha = 0.96). Convergent validity was supported by high correlations with other measures of physical function (r = 0.70-0.87). Known-groups validity by weight-bearing status and fracture severity was supported as was responsiveness (Mobility CAT effect size = 0.81; Physical Function Short Form 8a = 0.88). CONCLUSIONS: The PROMIS Mobility CAT and Physical Function 8a Short Form demonstrated reliability, convergent and known-groups discriminant validity, and responsiveness in a sample of patients with a lower extremity orthopaedic trauma injury.

AB - OBJECTIVES: To evaluate the reliability, convergent validity, known-groups validity, and responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility Computer Adaptive Test (CAT) and PROMIS Physical Function 8a Short Form. DESIGN: Prospective cohort study. SETTING: Two Level-I trauma centers. PATIENTS: Eligible adults with an isolated lower extremity trauma injury receiving treatment were approached consecutively (n = 402 consented at time 1, median = 80 days after treatment). After 6 months, 122 (30.3%) completed another assessment. INTERVENTION: Cross-sectional and longitudinal monitoring of patients. MAIN OUTCOME MEASUREMENTS: Floor and ceiling effects, reliability (marginal reliability and Cronbach's alpha), convergent validity, known-groups discriminant validity (weight-bearing status and fracture severity), and responsiveness (Cohen's d effect size) were evaluated for the PROMIS Mobility CAT, PROMIS Physical Function 8a Short Form, and 5 other measures of physical function. RESULTS: PROMIS PFSF8a and Foot and Ankle Ability Measure Activities of Daily Living Index had ceiling effects. Both PROMIS measures demonstrated excellent internal consistency reliability (mean marginal reliability 0.94 and 0.96; Cronbach's alpha = 0.96). Convergent validity was supported by high correlations with other measures of physical function (r = 0.70-0.87). Known-groups validity by weight-bearing status and fracture severity was supported as was responsiveness (Mobility CAT effect size = 0.81; Physical Function Short Form 8a = 0.88). CONCLUSIONS: The PROMIS Mobility CAT and Physical Function 8a Short Form demonstrated reliability, convergent and known-groups discriminant validity, and responsiveness in a sample of patients with a lower extremity orthopaedic trauma injury.

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